Intermaxillary fixation can be used as a pre-surgical solution for weight reduction in preparation for bariatric surgery, improving co-morbid aspects such as blood pressure, glycemia, and lipid profile.
Purpose: To evaluate the impact of submersion of the microsurgical anastomosis suture area using saline (0.9% NaCl) in an experimental laboratory during the training of medical students and resident physicians. Methods: Wistar rats (n = 10) were selected to have the two femoral arteries sectioned and anastomosed end-to-end under optical magnification. They were randomly divided, so that on one side suturing was performed under submersion with saline, and the contralateral side was kept dry during the procedure. The surgical times, as well as the patency within 30 min and 72 h of the procedure, were evaluated. Results: Six male Wistar rats survived the surgical anesthetic procedure, with the average initial weight of 243.3 g and the average artery diameter of 0.86 mm, with average time of 15.67 min for the submerged technique and 20.50 min for the dry technique (p = 0.03). The failure rates were 17 and 50% for the submerged group and the dry one, respectively (p = 0.62). Conclusion: Submerged microvascular suture does not compromise the patency of the vessel or increase the time of anastomosis. Therefore, it is a strategy that can be applied by the surgeon according to his/her technical preferences.
Surface treatment of medical devices may be a way of avoiding the need for replacement of these devices and the comorbidities associated with infection. The aim of this study was to evaluate whether pre- and postcontamination washing of 2 prostheses with different textures can decrease bacterial contamination. The following microorganisms were evaluated: Staphylococcus aureus , Staphylococcus epidermidis , Proteus mirabilis and Enterococcus faecalis . Silicone and expanded polytetrafluoroethylene vascular prostheses were used and divided into 3 groups: prostheses contaminated; prostheses contaminated and treated before contamination; and prostheses contaminated and treated after contamination. Treatments were performed with antibiotic solution, chlorhexidine and lidocaine. After one week of incubation, the prostheses were sown in culture medium, which was incubated for 48 hours. The area of colony formation was evaluated by fractal dimension, an image analysis tool. The antibiotic solution inhibited the growth of S epidermidis and chlorhexidine decrease in 53% the colonization density for S aureus in for both prostheses in the pre-washing. In postcontamination washing, the antibiotic solution inhibited the growth of all bacteria evaluated; there was a 60% decrease in the colonization density of S aureus and absence of colonization for E faecalis with chlorhexidine; and lidocaine inhibited the growth of S aureus in both prostheses. Antibiotic solution showed the highest efficiency in inhibiting bacterial growth, especially for S epidermidis , in both washings. Lidocaine was able to reduce colonization by S aureus in post-contamination washing, showing that it can be used as an alternative adjuvant treatment in these cases.
Staphylococcus aureus biofilms have been recognized as a leading cause of multiple infections, including implant-associated infections and chronic wounds. We evaluated the colonization capacity of two distinct textured prostheses by different bacterial strains. Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Proteus mirabilis and Enterococcus faecalis were evaluated. Initially, the hydrophobicity and biofilm formation capacity were determined. Subsequently, 20 fragments of vascular prosthesis and 20 silicone prostheses were embedded in suspensions with the microorganisms and incubated. The prostheses were then sown in culture medium and incubated for 48 hours. Petri dishes were photographed and analyzed by fractal dimension. The Kruskal-Wallis test and the Dunn test were applied for the analysis of biofilm formation. To compare the mean intensity for the type of bacteria and the type of prosthesis, a general linear model was applied. Staphylococcus aureus was the bacterium with the highest colonization density in both prostheses (p = 0.0001). E. coli showed strong adherence in the biofilm formation capacity test (p = 0.0001), however, it did not colonize either prosthesis. We demonstrated that Staphylococcus aureus has a greater affinity for vascular and silicone prostheses than other bacteria.
PURPOSE:To describe an animal model of rapid intravenous infusion with different volumes of crystalloid and discuss the clinical findings. METHODS:Fifty six male Wistar rats were used, divided randomly in seven groups (n = 8). The rats of groups 1 to 6 received lactated Ringer´s solution intravenously, in the rate of 25 ml/min, with different volumes proportional to blood volume (BV). The rats of group 0 were submitted to the same procedure, but did not receive the fluid (control group). The data included respiratory rate, heart rate, saturation of peripheral oxygen (SpO 2 ) in two times (before and after the infusion), and upshots (respiratory arrest and death). Dunnett´s test and ANOVA were used. RESULTS:The clinical signs significantly changed in the 2, 2.5 and 3 fold BV groups. The respiratory arrest was observed in the 1.5, 2, 2.5 and 3 fold BV groups, but death was present only in 2.5 and 3 fold BV groups. CONCLUSIONS:The infusion of crystalloid in the same volume of blood volume did not cause significant variation in respiratory and heart rate, saturation of peripheral oxygen and did not induce respiratory arrest. The infusion of a volume of 3 fold blood volume was lethal to all animals.
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